<div class="container">
	<div class="inner-content">
		<div class="signup">
			<div class="panel panel-default panel-zap">
				<div class="panel-heading">
					<h3 class="panel-title">Create an account</h3>
				</div>
				<div class="panel-body">
					<?php echo form_open(null, 'id="registration_form" class="form-horizontal"'); ?>
						<h4 class="form-signin-heading">Register here to become a member!</h4>
						<hr />
						<div class="form-group">
							<label for="inputEmail3" class="col-xs-12 col-sm-4 control-label fieldname">First Name:</label>
							<div class="col-xs-12 col-sm-12 col-md-8 login-txtbox-div">
								<input type="text" class="form-control" name="firstname" id="firstname" placeholder="First Name">
							</div>
						</div>
						<div class="form-group">
							<label for="inputEmail3" class="col-xs-12 col-sm-4 control-label fieldname">Last Name:</label>
							<div class="col-xs-12 col-sm-12 col-md-8 login-txtbox-div">
								<input type="text" class="form-control" name="lastname" id="lastname" placeholder="Last Name">
							</div>
						</div>
						<div class="form-group">
							<label for="inputPassword3" class="col-xs-12 col-sm-4 control-label fieldname">Email Address:</label>
							<div class="col-xs-12 col-sm-12 col-md-8 login-txtbox-div">
								<input type="text" class="form-control" name="email" id="email" placeholder="Email Address">
								<?php echo validation_errors(); ?>
							</div>
						</div>
						<div class="form-group">
							<label for="inputPassword3" class="col-xs-12 col-sm-4 control-label fieldname">Password:</label>
							<div class="col-xs-12 col-sm-12 col-md-8 login-txtbox-div">
								<input type="password" class="form-control" name="password" id="password" placeholder="Password" >
							</div>
						</div>
						<div class="form-group">
							<label for="inputPassword3" class="col-xs-12 col-sm-4 control-label fieldname">Confirm Password:</label>
							<div class="col-xs-12 col-sm-12 col-md-8 login-txtbox-div">
								<input type="password" class="form-control" name="cpassword" id="cpassword" placeholder="Confirm Password">
							</div>
						</div>
						<div class="form-group">
							<div class="col-sm-offset-4 col-sm-8 login-btn-div">
								<input type="checkbox" class="check" name="terms"> I agree to the <a href="<?php echo base_url('conditions'); ?>" target="_blank">terms and conditions</a>
							</div>
						</div>
						<div class="form-group">
							<div class="col-sm-offset-4 col-xs-12 col-sm-4 login-btn-div">
								<button class="btn btn-default login-btn" type="submit">Join Now</button>
							</div>
						</div>
					<?php echo form_close(); ?>
				</div>
			</div>
		</div>
		<div class="shadow-img">&nbsp;</div>
	</div>
</div>